Getting out, military health issues - Marine Corps Times

Tricare Reserve Select

Members of the Selected Reserves can buy Tricare coverage when they are in drilling status — not mobilized — provided they meet specific criteria under a program called Tricare Reserve Select.

The program, which offers coverage similar to Tricare Standard and Extra, was originally designed to cover reservists called up in support of contingency operations for more than 30 days. It has since been expanded to all drilling reservists under three tiers of eligibility, with monthly premiums increasing for each tier.

The first tier of eligibility remains reservists who were called to active duty to serve in a contingency operation on or after Sept. 11, 2001, for more than 30 consecutive days, and served under those orders continuously for at least 90 days, unless they were injured or became sick during that time.

Reservists eligible for Tier 2 include those who are receiving unemployment compensation; those whose private-sector employers do not offer health coverage or are in a category of employees who do not qualify for employer-sponsored health coverage; and those who are self-employed.

Tier 3 is for all other Selected Reserve members.

Anyone who wants to get into Tricare Reserve Select must agree to serve in the Selected Reserve for the number of whole years chosen for TRS coverage.

Monthly premiums under Tier 1 are $81 for an individual and $253 for family coverage, including the service member and dependents; $145.29 for an individual and $451.42 for a family under Tier 2; and $247 for an individual and $767.41 for a family under Tier 3. Defense officials announced in the fall of 2006 that those rates would remain in effect at least through Sept. 20, 2007.

Coverage includes medical, behavioral health and prescription drug benefits. For office visits, patients pay 15 percent of the allowable charge if the health care professional providing the service is in the network, and 20 percent if not.

Outpatient services are subject to deductibles that apply each fiscal year. Annual deductibles for paygrades E-4 and below are $50 for an individual and $100 for a family. For higher ranks, the annual deductibles are $150 for an individual and $300 for a family. The catastrophic cap is $1,000 a year.

Contact: A complete overview of Tricare Reserve Select is online at www.tricare.osd.mil/reserve/reserveselect/index.cfm.